Leukemic CNS involvement

Leukemic involvement of the central nervous system is among the newest diagnoses for proton therapy.

Irradiation of the craniospinal axis is beneficial for patients who, despite intensive systemic treatment, have:

• positive finding of leukemic cells in the cerebrospinal fluid,
• as well as for those who had a positive cerebrospinal fluid already at the diagnosis and who are at risk for central nervous system involvement in the future.

The objective is to get rid of leukemic cells in these hard-to-access areas, including those that are not sensitive to chemotherapy or biological treatment.

In such case, proton radiotherapy has substantial benefits when compared with other forms of radiotherapy. These include no radiation strain on organs in front of vertebral bodies and minimal systemic toxicity (reduced occurrence of nausea, vomiting, diarrhoea), and it is suitable for highly pre-treated patients with necessary reduction of the dose to the lungs, sigmoid colon, heart and other organs.